Targeted therapy of stomach cancer

Introduction Gastric cancer (GC), also known as stomach cancer, is a major health problem. According to the last update of the World Health Organization (WHO), GC is the fifth most common cancer worldwide and the fifth leading cause of cancer-related deaths. Additionally, the incidence of gastric cancer among young adults has gradually increased. Due to the lack of identifying clinical symptoms in GC, many patients are diagnosed at advanced stages with poor prognoses. There are different types of treatments. Surgery is the primary treatment, but as aforementioned many patients are diagnosed with advanced disease, limiting surgery's effectiveness. Chemotherapy, with a low response rate of ۲۰-۴۰%, has significant side effects. As a result of numerous recent investigations, molecular targeted therapy, which focuses on the effective inhibition of overexpressed molecules and signaling pathways in tumor cells, offers promising advancements in cancer treatment. Targeted therapy provides a specialized approach to cancer treatment by directly targeting the proteins that regulate the growth, division, and spread of cancer cells. This study aims to review the available evidence on the targeted therapy of gastric cancer. Methods A comprehensive search was conducted in online databases including PubMed, Web of Science, Scopus, and Google Scholar. The keywords were "Gastric Cancer", “Stomach Cancer” and “Targeted Therapy". The search covered the period from ۲۰۰۰ to ۲۰۲۴. Articles in English were just considered. ۱۱۱۲ results were found and ۲۰ original studies completely related to the topic were selected and evaluated. Review articles, book chapters, and conference papers were excluded from the study. Results Based on the results of the reviewed articles, the prospects for targeted therapy in gastric cancer are promising. The common items are as follows: Trastuzumab and Ramucirumab are humanized monoclonal antibodies that are approved by the FDA (Food and Drug Administration) in gastric cancer treatment. These agents directly target specific molecules on tumor cells to disrupt the subsequent signaling pathways. Trastuzumab is used for patients with HER۲-positive gastric cancer. Also, studies show that a combination of these agents and chemotherapy has better outcomes. Other such treatments are also under investigation. Proton therapy, which is a common form of external beam radiation therapy and based on the manipulation of the Bragg peak of this beam, can treat the tumor by delivering high levels of dose to the tumor while sparing the surrounding healthy tissues from radiation. Proton therapy for stomach cancer can represent an almost ideal radiation therapy by determining the number of risks caused by the dose of secondary particles, especially the dose equivalent to neutrons. Helicobacter Pylori eradication can prevent stomach cancer, but considering that carcinogenesis is a multi-stage process and it is not clear at which stage the eradication of Helicobacter pylori prevents the cancer onset, this method cannot be used for sure. Conclusion Overall, the studies indicate that there are numerous targeted therapies for gastric cancer such as monoclonal antibodies, Proton therapy, Helicobacter Pylori eradication, etc. Among these therapies, monoclonal antibodies are used widely and are especially effective. However, challenges remain, particularly regarding prevention and the exact mechanisms of cancer progression.

کلیدواژه ها:

Gastric Cancer ، Stomach Cancer ، Targeted Therapy